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Gum Hypertrophy in Patients in Fixed Orthodontic Therapy Treated with Topical Probiotic Lactobacillus Reuteri: a Pilot Study †

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Gum Hypertrophy in Patients in Fixed Orthodontic Therapy Treated with Topical Probiotic Lactobacillus Reuteri: a Pilot Study † Extended Abstract Gum Hypertrophy in Patients in Fixed Orthodontic Therapy Treated with Topical Probiotic Lactobacillus † Reuteri: A Pilot Study Antonia Sinesi 1,*, Giovanna Mosaico 2, Martina Cont 3, Savino Cefola 4, Giovanni Mautarelli 5 and Cinzia Casu 6 1 RDH, Freelancer, 76012 Canosa di Puglia, Italy 2 RDH, Freelancer, 76012 Brindisi, Italy; [email protected] 3 RDH, Freelancer, 38014 Trento, Italy; [email protected] 4 DDS, Private Dental Practice, 76012 Barletta, Italy; [email protected] 5 DDS, Private Dental Practice, 76112 Brindisi, Italy; [email protected] 6 DDS, Private Dental Practice, 09126 Cagliari, Italy; [email protected] * Correspondence: [email protected] † Presented at the XV National and III International Congress of the Italian Society of Oral Pathology and Medicine (SIPMO), Bari, Italy, 17–19 October 2019. Published: 12 December 2019 1. Introduction Patients undergoing in fixed orthodontic treatment could have higher risk in periodontal/gum disease development, such as gingival hypertrophies. Different types of therapies have been proposed for the treatment of this condition, such as traditional surgery, laser therapy and the use of chlorhexidine mouthwashes [1–3]. The aim of this pilot study is to evaluate the use of a topical probiotic with Lactobacillus Reuteri in the treatment of patients with gingival hypertrophy in orthodontic therapy. 2. Materials and Methods For this study, 14 patients (10 females and 4 males) with gingival hypertrophy of the incisal group in fixed orthodontic therapy, were considered (Figure 1). Topical probiotics with Lactobacillus reuteri DSM 17,938 and ATCC PTA 5289 were used to treat gingival hyperplasia. At the first session periodontal clinical parameters were recordered (T0) and after debridement, topical application were made. The probiotic gel is made by powdered tablets in a 1% Gel Carbopol; The gel was injected into the pockets until the spill, for 3–5 min the patient did not rinse the mouth and was advised not to eat and drink for about an hour. Systemic probiotics of Lactobacillus Reuteri taken at home 2 times a day were prescribed. After 1-month periodontal clinical parameters were re-evaluated (T1). Figure 1. 19 years old male patient before and after treatment. Proceedings 2019, 35, 40; doi:10.3390/proceedings2019035040 www.mdpi.com/journal/proceedings Proceedings 2019, 35, 40 2 of 2 3. Results The mean age of the patient was 14.8 years old. All patients showed a complete regression of gingival hypertrophies (Figure 2) at one month of follow up (100%). The mean value of plaque index (PI) before therapy was 69.71%, while at one month it was 18.57%. The average value of the bleeding index (BoP) was 37.85% while at one month after treatment it was 2.35%. Figure 2. 14 years old female patient before and after the treatment. 4. Discussion and Conclusions All gingival lesions regressed after treatment, while PI was reduced by more than 3.5 times. The average BoP values are reduced so as to be negligible. A previous study has tested the use of two mouthwashes for the treatment of this condition, but the authors concluded that “none of these principals, although the gingival condition improved, could reduce gingival enlargement to the clinically acceptable level of health [1]”. Other works suggest a surgical removal, with or without laser of the excess gum tissue [2,3]. No other works in the literature has used topical probiotics for the treatment of gingival hypertrophies in orthodontic patients, which from our observation proved to be effective and safe because they had no side effects. Studies with a larger sample and with greater follow-up are necessary to confirm these preliminary results. Reference 1. Farhadian, N.; Bidgoli, M.; Jafari, F.; Mahmoudzadeh, M.; Yaghobi, M.; Miresmaeili, A. Comparison of Electric Toothbrush, Persica and Chlorhexidine Mouthwashes on Reduction of Gingival Enlargement in Orthodontic Patients: A Randomised Clinical Trial. Oral Health Prev. Dent. 2015, 13, 301–307. 2. Jadhav, T.; Bhat, K.M.; Bhat, G.S.; Varghese, J.M. Chronic inflammatory gingival enlargement associated with orthodontic therapy case report. J. Dent. Hyg. 2013, 87, 19–23. 3. Gama, S.K.; De Araújo, T.M.; Pozza, D.H.; Pinheiro, A.L. Use of the CO2 laser on orthodontic patients suffering from gingival hyperplasia. Photomed. Laser Surg. 2007, 25, 214–219. © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). .
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